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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Timing of enteral nutrition in acute pancreatitis: Meta-analysis of individuals using a single-arm of randomised trials
Pancreatology, Volume 14, No. 5, Year 2014
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Description
Introduction In acute pancreatitis, enteral nutrition (EN) reduces the rate of complications, such as infected pancreatic necrosis, organ failure, and mortality, as compared to parenteral nutrition (PN). Starting EN within 24 h of admission might further reduce complications.; Methods A literature search for trials of EN in acute pancreatitis was performed. Authors of eligible trials were requested to provide the data of all patients in the EN-arm of their trials. A meta-analysis of individual patient data was performed. The cohort of patients with EN was divided into patients receiving EN within 24 h or after 24 h of admission. Multivariable logistic regression, adjusting for predicted disease severity and trial, was used to study the effect of timing of EN on a composite endpoint of infected pancreatic necrosis, organ failure, or mortality.; Results Observational data from 165 individuals from 8 randomised trials were obtained; 100 patients with EN within 24 h and 65 patients with EN after 24 h of admission. In the multivariable model, EN started within 24 h of admission compared to EN started after 24 h of admission, reduced the composite endpoint from 45% to 19% (adjusted odds ratio [OR] of 0.44; 95% confidence interval [CI] 0.20-0.96). Within the composite endpoint, organ failure was reduced from 42% to 16% (adjusted OR 0.42; 95% CI 0.19-0.94).; Conclusions In this meta-analysis of observational data from individuals with acute pancreatitis, starting EN within 24 h after hospital admission, compared with after 24 h, was associated with a reduction in complications. © 2014, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.
Authors & Co-Authors
Louie, Brian E.
Unknown Affiliation
Oláh, Attila
Unknown Affiliation
O'Keefe, S. J.
United States, Pittsburgh
University of Pittsburgh
Besselink, Marc G.H.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
van Santvoort, Hjalmar C.
Netherlands, Utrecht
University Medical Center Utrecht
Rovers, Maroeska M.
Netherlands, Nijmegen
Radboud University Medical Center
Statistics
Citations: 52
Authors: 6
Affiliations: 9
Identifiers
Doi:
10.1016/j.pan.2014.07.008
ISSN:
14243903
Research Areas
Food Security
Health System And Policy
Study Design
Cohort Study
Case-Control Study
Study Approach
Systematic review